BVA9506420 DOCKET NO. 93-08 490 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to service connection for left knee arthritis. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant INTRODUCTION The veteran served on active duty from December 1964 to September 1967. This matter came before the Board of Veterans' Appeals (Board) on appeal from a January 1992 rating decision from the Columbia, South Carolina, Regional Office (RO). CONTENTIONS OF APPELLANT ON APPEAL It is contended that left knee arthritis is due to the service- connected right knee disability. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the evidence supports the claim for service connection for left knee arthritis. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. The veteran is service connected for ankylosis of the right knee. Shortening of the right knee was identified in 1979. 3. Left knee arthritis developed after the right knee pathology and shortening of the right lower extremity. The arthritis is due to strain. CONCLUSION OF LAW Left knee arthritis is attributable to right lower extremity ankylosis and shortening. 38 U.S.C.A. § 5107 (West 1991); 38 C.F.R. § 4.58 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107 (West 1991). He has presented a claim that is plausible. We are satisfied that all relevant facts have been properly developed. No further assistance to the veteran is required to comply with the duty to assist the veteran mandated by 38 U.S.C.A. § 5107. The veteran is service connected for right knee ankylosis. In September 1979, a Department of Veterans Affairs (VA) examination disclosed that the knee was fused and that there was 1-inch shortening of the extremity. It was also noted that there was a postural imbalance. In May 1980, a VA X-ray examination disclosed associated bony changes in the right knee. In August 1989, an X-ray examination of the left knee was negative for pathology. In August 1992, a VA examiner entered the opinion that the left knee disability had the contributing factor "from the stress imposed on the leg by the right knee fusion and leg length discrepancy." In 1993, a VA examiner determined that the veteran had degenerative joint disease about the left knee. The altered gait mechanics of the right knee could certainly have contributed to his symptoms of degenerative joint disease on the left. When all the evidence is assembled, the Secretary, is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet.App. 49, 55 (1990). At this time, the record contains two medical opinions to the effect that the service- connected right lower extremity disability contributed to the left knee joint disease (as distinguished from aggravating an already existing knee disability). The veteran is service connected for right knee fusion; there is right lower extremity shortening; there is a long history of gait imbalance; there are associated bony changes in the right knee; joint disease was identified in the left knee; and examiners have attributed the left knee disability to the strain caused by the right knee fusion and leg length discrepancy. A regulation stipulates that: With service-incurred lower extremity amputation or shortening, a disabling arthritis, developing in the same extremity, or in both lower extremities, with indications of earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however, that arthritis affecting joints not directly subject to strain as a result of the service-incurred amputation will not be granted service connection. This will generally require separate evaluation of the arthritis in the joints directly subject to strain. 38 C.F.R. § 4.58 (1994). This regulation was not considered by the regional office. Based upon the opinions of the examiners, the regulation, and the absence of contrary probative evidence, there is no doubt to be resolved. Service connection for left knee arthritis due to strain (traumatic arthritis) is warranted. ORDER Service connection for left knee arthritis due to strain is granted. H. N. SCHWARTZ Member, Board of Veterans' Appeals (CONTINUED ON NEXT PAGE) The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.